Glucagon-like peptide-1 receptor agonists are associated with cardiac, cancer- and mortality-related benefits in diabetic patients treated with anthracyclines

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ID: 318735
2026
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Abstract
Abstract Background Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce major adverse cardiovascular events in diabetics. This study aimed to investigate the cardiac, cancer, and overall mortality effects of GLP-1RA in diabetics treated with anthracyclines. Methods We retrospectively identified 1,384 diabetics treated with anthracyclines from 2013 to 2023; 56 received GLP-1 RAs between their first and last dose of anthracycline. These patients were propensity score matched 4:1 to 224 controls without concurrent GLP-1 RA use. Because stage was not available for 10 of the 56 patients, a repeat analysis was conducted with additional matching for cancer stage in 46 cases and 92 controls. Major endpoints were rate of all-cause and cancer- and cardiovascular disease (CVD)-related mortality, no evidence of disease (NED), and hospitalization for CVD including heart failure (HF), over 5 years. Survival analyses were conducted using cause-specific hazards Cox regression. Results Patients on GLP-1 RAs had a significantly lower 5-year overall mortality (HR 0.46, CI 0.24-0.87, P = 0.007) and cancer-related mortality (HR 0.42, CI 0.19-0.91, P = 0.03). This mortality risk reduction remained significant even when accounting for covariates (HR 0.39, CI 0.20-0.75, P = 0.002). The percentage of patients with NED was higher in the GLP-1 RA than control group (60.9% vs. 38.0%, p = 0.007). A decline in LVEF was seen in controls but not in patients on GLP-1 RAs. There was no significant difference in CVD hospitalization; the rate of HF-related hospitalization was very low overall. Conclusion GLP-1 RAs may offer survival benefits and better cancer- and cardiac function-related outcomes in diabetics undergoing anthracycline chemotherapy.
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Authors Sunnia T. Chen, Teodora Donisan, Bradley R. Lewis, Vidur Kailash, Sandra M. Herrmann, Kathryn J. Ruddy, David Yat Chung Cheung, Danielle Desautels, Davinder S. Jassal, Joerg Herrmann
Journal European Heart Journal Open
Year 2026
DOI
10.1093/ehjopen/oeag109
URL
https://doi.org/10.1093/ehjopen/oeag109
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